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PROJECT <br />Owner <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857—www.everettwa.org <br />Address <br />City <br />WA. y'fao q <br />1a`X3 --13 <br />5-- <br />State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />'W 50CLa.71d os 7302- A "%' tvwk UA %40Z 2 53-5 7Z-W?, <br />Electrical Contractor Mail Address City State/Zip Phone <br />SMc 505 L <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: /e✓51w f- -/awi-, 0—ma raj... A;a *4A4ty e-r Roes *17 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which applicatiog4 m ee-�nd I comply with the State Contractors Law 18.27 RCW and <br />7-.; <br />FEE <br />`aC 3.5 <br />PERMIT# <br />E 1 a� a -- t�3 <br />REVISED W0/13 <br />